Marques-Magallanes J A, Koyal S N, Cooper C B, Kleerup E C, Tashkin D P
Department of Medicine, UCLA School of Medicine, Los Angeles, CA 90095-1690, USA.
Chest. 1997 Oct;112(4):1008-16. doi: 10.1378/chest.112.4.1008.
Habitual smoking of alkaloidal cocaine (crack) has been reported to be associated with a number of cardiopulmonary complications that may not be clinically obvious but could potentially interfere with normal physiologic responses to exercise and thus impair maximum exercise performance.
To evaluate the impact of regular use of cocaine on maximum exercise.
Observational study in crack users and age- and gender-matched control subjects.
Thirty-five habitual cocaine smokers (21 male and 14 female) and 29 age-matched sedentary control nonsmokers of cocaine (15 male and 14 female), all of whom were in good general health.
In these subjects, we compared physiologic responses to symptom-limited, incremental maximal exercise performed on a cycle ergometer using a ramp protocol. Comparisons were made for men and women separately.
For both men and women, long-term cocaine smokers had a reduced aerobic capacity (maximum oxygen consumption) compared with control nonsmokers but did not show evidence of ventilatory limitation, reduced gas exchange threshold, increased physiologic dead space, or gas exchange abnormality at maximum exercise compared with the healthy control subjects. Although cocaine smokers had reduced maximum heart rates compared with control subjects, the relationship between submaximal heart rate and oxygen uptake was normal, indicating a normal cardiovascular response pattern. However, effort perception was similar between the two groups despite the difference in heart rate at maximum exercise, suggesting the possibility of perceptual dysfunction for effort. Differences in aerobic capacity between the crack users and nonusers could not be explained by differences in physical fitness or altered perception of dyspnea.
In the subjects we studied, long-term cocaine smoking was associated with reduced maximum exercise performance, probably due to poor motivation or altered effort perception. No other identifiable physiologic abnormality appeared to limit exercise in the habitual crack users.
据报道，习惯性吸食生物碱可卡因（快克）与多种心肺并发症有关，这些并发症在临床上可能并不明显，但可能会干扰对运动的正常生理反应，从而损害最大运动能力。
评估定期使用可卡因对最大运动能力的影响。
对快克使用者以及年龄和性别匹配的对照受试者进行观察性研究。
35名习惯性吸食可卡因者（21名男性和14名女性）以及29名年龄匹配的久坐不动的不吸食可卡因的对照者（15名男性和14名女性），所有受试者总体健康状况良好。
在这些受试者中，我们比较了使用斜坡方案在自行车测力计上进行症状限制的递增最大运动时的生理反应。分别对男性和女性进行了比较。
对于男性和女性而言，长期吸食可卡因者与对照不吸烟者相比，有氧能力（最大耗氧量）降低，但在最大运动时未显示出通气受限、气体交换阈值降低、生理死腔增加或气体交换异常的证据。尽管吸食可卡因者与对照受试者相比最大心率降低，但次最大心率与摄氧量之间的关系正常，表明心血管反应模式正常。然而，尽管最大运动时心率存在差异，但两组之间的用力感知相似，这表明存在用力感知功能障碍的可能性。快克使用者和非使用者之间有氧能力的差异无法通过身体素质差异或呼吸困难感知改变来解释。
在我们研究的受试者中，长期吸食可卡因与最大运动能力降低有关，可能是由于动力不足或用力感知改变。在习惯性快克使用者中，未发现其他可识别的生理异常限制运动。
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